NPI | 1346611159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60167) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002921) |
Enumeration Date | 2015-10-19 |
Last Update Date | 2015-10-19 |